Changes in insulin resistance, glucose effectiveness, and first and second phases of insulin secretion in women aged 45-60 years old in Taiwan

Chen-Yu Wang; Chung-Ze Wu; Fang-Yu Chen; Dee Pei; Li-Ying Huang

doi:10.1097/JCMA.0000000000000976

Changes in insulin resistance, glucose effectiveness, and first and second phases of insulin secretion in women aged 45-60 years old in Taiwan

J Chin Med Assoc. 2023 Oct 1;86(10):897-901. doi: 10.1097/JCMA.0000000000000976. Epub 2023 Aug 10.

Authors

Chen-Yu Wang¹, Chung-Ze Wu^{2

3}, Fang-Yu Chen⁴, Dee Pei⁴, Li-Ying Huang⁴

Affiliations

¹ Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
² Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, ROC.
³ Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.
⁴ Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC.

PMID: 37559215
DOI: 10.1097/JCMA.0000000000000976

Abstract

Background: In women after menopause, the incidence of diabetes mellitus increases. Increased insulin resistance (IR), decreased glucose effectiveness (GE), and the first and second phases of insulin secretion (FPIS and SPIS), are the four most important factors that trigger glucose intolerance and diabetes (diabetogenic factor [DF]). In the cross-sectional study, we enrolled nondiabetic women between the ages of 45 and 60 years to observe the changes in DFs during the perimenopausal period and to elucidate the underlying mechanisms of diabetes in menopausal women.

Methods: We randomly enrolled 4194 women who underwent health checkups. Using demographic and biochemical data, IR, FPIS, SPIS, and GE were calculated using previously published equations. The relationship between the DFs and age was evaluated using a simple correlation.

Results: Body mass index, blood pressure, fasting plasma glucose, low-density lipoprotein cholesterol, triglyceride, and SPIS were higher, and GE was lower in older women (≥52 years old). A significant decrease in GE and increased SPIS were observed with age. However, no changes were observed in IR or FPIS.

Conclusion: The IR and FPIS did not change during perimenopause. Increased SPIS may compensate for the decrease in GE, which is probably one of the reasons for the higher incidence of diabetes in menopausal women.